Nebraska Workers’ Compensation Claims: Eligibility, Filing, and Appeals

Updated November 29, 2018

The workers' compensation system in Nebraska is a no-fault system that compensates injured workers for medical bills, lost wages, and permanent impairments resulting from their injuries. To take advantage of these benefits, injured workers must follow certain procedures required by Nebraska law.

Who Is Eligible for Workers' Comp Benefits?

All employers in Nebraska with one or more employees must carry workers' compensation insurance, and it covers almost all employees in Nebraska. However, there are a few exceptions for employees engaged in certain types of work. For example, workers' comp does not cover domestic household workers or certain farm workers, unless the employer chooses to provide coverage.

Workers' compensation covers all injuries or illnesses that happen in the course of employment, including traumatic injuries and occupational illnesses. Traumatic injuries are those that result from a one-time accident at work, such as a broken bone from a slip and fall. Occupational diseases are injuries or illnesses that occur over a period of time, such as injuries caused by repetitive movements at work (for example, carpal tunnel syndrome) and illnesses developed from exposure to toxic substances at the workplace (for example, cancer from exposure to asbestos).

What Should I Do if I'm Injured at Work?

To reserve your right to benefits, you must report your injury to your employer as soon as it is practical. Depending on the severity of your injuries, this might be within a day or two. On the other hand, it might be longer if you are in the hospital with serious injuries and cannot ask anyone to notify your employer on your behalf. Once your employer has notice, it will notify its insurance company. The insurance company will then decide whether to accept or deny your claim.

How Do I Get Medical Treatment?

Once you give notice of your injury, your employer should let you know that you have the right to select a treating doctor. However, the doctor must be someone who has treated you or an immediate family member in the past. If you don't have such a doctor, your employer can choose your treating physician.

However, you can select any treating doctor—even one with whom you have never treated—in the following situations:

• if your employer fails to tell you of your right to select a treating doctor who has treated you or family member
• for emergency medical care
• for major surgeries, or
• if your injury involved a dismemberment.

Once you have a treating doctor in your workers' comp case, you will need your employer's approval before switching to another treating doctor. This is true regardless of who selected your treating doctor.

What Benefits Can I Receive?

All reasonable and necessary medical treatment related to your work injury will be covered through workers' comp, including the cost of doctors' visits, hospital bills, prescriptions, and prosthetic devices. You can also be reimbursed for the mileage you incur in traveling to and from medical appointments. In addition to medical benefits, you will also be eligible to receive disability benefits.

Total Disability Benefits

Nebraska provides total disability benefits to workers who are completely unable to work due to their injuries. These benefits are two-thirds of your average weekly wages, subject to a weekly minimum and maximum that is updated each year. For 2018, the weekly minimum is $49, and the weekly maximum is $831.

These benefits are called temporary total disability benefits while you are still recovering from your work injuries. You can receive these benefits until you're able to return to work or until you reach "maximum medical improvement" (MMI)—the point at which your condition has stabilized and has improved as much as it is going to. If you are still completely unable to work after reaching MMI, you can continue receiving these benefits as permanent total disability benefits.

Temporary Partial Disability Benefits

If you are able to work while you are recovering from your injuries, but you are making less than you used to, you can receive temporary partial disability benefits. These benefits are two-thirds of the difference in your earnings, subject to the same maximum as total disability benefits. You can receive these benefits for as long as your wage loss continues, up to a maximum of 300 weeks.

Permanent Partial Disability Benefits

Once you reach maximum medical improvement, you will be evaluated for a permanent disability. If you have a permanent disability, but you are still able to work in some capacity, you can receive permanent partial disability benefits. The amount and duration of these benefits depend on whether the injury is listed on a state schedule.

Nebraska's schedule lists injuries to certain body parts—such as a hand, arm, leg, foot, finger, toe, eye, and ear—and designates a maximum number of weeks for which benefits are paid. You can receive two-thirds of your average weekly wages, subject to the same maximum as total disability benefits, for the number of weeks listed in the schedule. For example, the schedule allows a worker to receive benefits for 150 weeks for the total loss of use of a foot. The award is typically paid in one lump sum. (But if you don't have a lawyer, you must file a Lump Sum Settlement Application with the Nebraska Workers' Compensation Court.)

If your injury is not listed on the schedule—such as a back or head injury—you will be considered to have a permanent partial disability as to the body as a whole. Your benefits will be two-thirds your average weekly wage, subject to the same maximum as total disability benefits, times your percentage of disability. These benefits are available for up to 300 weeks, minus any weeks that you've already received temporary or permanent disability benefits.

What If My Claim Is Denied or I Have a Dispute With the Insurance Company?

If your workers' comp claim has been denied, or you have a dispute with the insurance company about your benefits, you can challenge the decision with the Nebraska Workers' Compensation Court.

If the insurance company denies your claim, you can file a petition with the Nebraska Workers' Compensation Court.

Filing a Petition

To start your appeal of a denial, you must file a petition with the Nebraska Workers' Compensation Court. The petition form is available at the Nebraska Workers' Compensation Court website. You must file this petition within two years of your injury or the last benefit payment you received from the insurance company.

Once the court receives your petition, it will notify the insurance company. The insurance company will have 14 days to file a response. Your case will then be assigned to a workers' comp judge and scheduled for a hearing.

Mediation

Before your hearing takes place, you can try to informally resolve the dispute with the insurance company through mediation. A mediation is an informal conference, where a neutral third party will try to help you and the insurance company reach a voluntary settlement agreement. Mediations are conducted either in person or over the phone. To request mediation, you must file an Informal Dispute Resolution Request Form with the Workers' Compensation Court.

Hearing

Most workers' compensation cases are settled through informal negotiations with the insurance company. However, if you're not able to resolve the dispute, you will continue on to an administrative hearing before a workers' compensation judge. Both you and the insurance company will have an opportunity to submit documents, present testimony from witnesses, and make legal arguments. The judge will review the evidence and mail a written decision after the hearing.

Appealing the Judge's Decision

If you are not happy with the judge's decision, you can appeal to the Nebraska Court of Appeals. To do so, you must file your appeal with the Workers' Compensation Court within 30 days of the judge's decision. You must submit the following three documents: a notice of appeal, a praecipe for transcript (requesting all of the procedural legal documents filed in your case), and a request for bill of exceptions (requesting the evidence and testimony presented at the hearing).

A panel of three judges will review your case and make a decision. The panel will not hold another hearing and will base its decision only on the written record of your case. You will receive the panel's decision in the mail.

Getting Help

While it's not a requirement, most workers with contested workers' compensation cases hire lawyers to represent them in the appeals process. The appeals process requires detailed knowledge of workers' compensation law and procedural rules, especially when it comes to presenting your case at a workers' compensation trial. For help finding a workers' compensation lawyer, check out our online lawyer directory.